Ketogenic Diet

The ketogenic diet is a treatment for epilepsy that relies on inducing a state
of ketosis. The diet prescribes foods high in fat, and heavily restricts
carbohydrate intake. As fats become the body's primary source of metabolic
energy, ketones accumulate in the brain, which can alleviate epileptic
symptoms. The diet is more effective in children than adults, particularly
when anticonvulsant drug therapy is ineffective (20%-30% of patients)
or contraindicated.

The diet provides 3-4 grams of fat for every 1 gram of carbohydrate,
calling for such foods as high-triglyceride dairy products (butter,
cream, mayonnaise) and peanut butter. Carbohydrates, found in breads
and starches, are eliminated from the diet, and liquid intake is often
restricted as well in order to aid ketone accumulation. Though superficially
similar, this is not the same as the Atkins diet. Possible long-term
side effects of the diet include:

The diet is typically supplemented with calcium, vitamin D, iron, and
folic acid.

Among the possible reasons the diet was not widely adopted by doctors:

* Lack of double blind studies. (see below)
* Concerns about patient compliance with diet
* Concerns about potential nutritional deficiency
* It is possible that early anti-convulsants were statistically more
effective than diets as treatment for new patients but that they worked
on separate population groups.

The TV movie First Do No Harm increased awareness of the Ketogenic
diet, though a curative link between fasting and epilepsy was even mentioned
in the Bible.

Scientific Studies

A study conducted by Johns Hopkins reported that 50% of those patients
starting the ketogenic diet reported a decrease in seizures of 50% or
more, with 29% of patients reporting a 90% reduction in symptoms; these
patients had previously tried an average of six anticonvulsant drugs.
The success rate on patients who responded to anticonvulsants was not
measured in that study (and appears to be lacking in other recent studies
as well - there appears to be reluctance to try the diet on subjects
except as a last resort). The success rate of the diet on those who
are successfully treated with anti-convulsants may be higher, lower,
or the same as those who do not respond. It may be that the diet and
anti-convulsants are effective on different segments of the population.

The ketogenic diet has been reported to work in cases where multiple
epilepsy drugs have failed. There may also be cases where the ketogenic
diet has failed and epilepsy drugs succeeded. When one epilepsy drug
fails, there is a high likelihood that other drugs will also fail. When
the diet works, the response is often rapid and dramatic.

Double Blind Studies

Lack of double blind studies is an issue preventing wider acceptance
by the medical profession. Reliance on proper studies rather than anecdotal
evidence or flawed studies is important. Double blind studies help eliminate: